Respiratory Medicine - Science topic

ASCVD is a global concern as it has become central to significant morbidity and mortality. LDL-C is the most important modifiable risk factor in developing ASCVD. Therefore, lowering LDL-C levels is paramount to tackling ASCVD; the lower the LDL-C, the better. Finding the right combination of medications patients are willing to adhere to is necessa...

Background Human metapneumovirus (HMPV) has been increasingly appreciated as a cause of lower respiratory tract infection among children. The purpose of this paper is to determine the radiographic and clinical features of children with HMPV lower respiratory disease. Case Presentation We reviewed seven pediatric patients with severe pneumonia due...

Recent advancements in diagnostic technologies have significantly transformed the landscape of respiratory medicine, aiming for early detection, improved specificity and personalized therapeutic strategies. Innovations in imaging such as multi-slice computed tomography (CT) scanners, high-resolution CT and magnetic resonance imaging (MRI) have revo...

Purpose Patient participation is essential for improving patient safety and quality of care. It mainly refers to patients participating in their own healthcare through various ways, such as searching information on treatment options, engaging in decision-making, and communicating with healthcare professionals. This study aimed to investigate the re...

We present the case of an ANCA+ EGPA patient with a long disease history and remission for over 8 years (between 2015 and 2023), who developed a life‐threatening relapse marked by diffuse alveolar haemorrhage and mononeuritis multiplex despite low dose mepolizumab (100 mg q4w) maintenance therapy. She was treated with pulse dose corticosteroids, ri...

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, yet life-threatening hypersensitivity reaction. It typically presents with fever, lymphadenopathy, eosinophilia and systemic organ dysfunction. Atypical presentations of DRESS syndrome, including elevated liver enzymes and acute respiratory distress syndrome, have pre...

Background Lower respiratory infections are the leading cause of illness and death in children under 5, primarily due to respiratory syncytial virus(RSV). Climate and pollution influence disease and pathogen prevalence. This study investigates the correlation between meteorological factors, atmospheric pollutants, and RSV infections in children, ai...

Respiratory diseases, including chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and lung cancer, exhibit elevated death rates and pathological intricacy, requiring advancements that surpass the constraints of traditional therapies. This study comprehensively outlines the novel applications of nanomaterials in resp...

Background: Nebulization therapy is an essential inhalation technique for managing obstructive airway diseases such as asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). In Indian clinical settings, factors such as diverse patient populations, varying disease severity, and healthcare accessibility influence treatment decision...

Accurate classification of lung function impairments is central to diagnosing and managing a wide range of respiratory conditions, including chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease. Traditional diagnostic methods rely heavily on isolated spirometry readings, which can be limited by test quality, patient v...

Pink disease was once a widespread phenomenon, known to physicians throughout the Western world. Its prevalence declined massively once the source, mercury, was identified in several products. In modern medicine, pink disease rarely forms a differential and is known only to few physicians, despite the long-term effects of this illness. This report...

Background Currently, Endobronchial ultrasound (EBUS) and rapid on-site evaluation (ROSE) are extensively utilized in the clinical practice of respiratory medicine. The combined diagnostic approach has been shown to enhance the clinical diagnostic accuracy; however, certain controversies remain. Methods This study included 200 patients who underwe...

Background Budd-Chiari syndrome (BCS) is a hepatic venous system disease caused by obstruction of the hepatic blood flow outflow tract. The definition of hemothorax is that blood accumulates in the chest cavity, and the hematocrit value of the effusion exceeds 50%. Hemothorax caused by intrathoracic variceal rupture associated with BCS is rare. Ca...

Background/Objectives: Despite documented benefits across multiple outcome areas, referral and uptake into pulmonary rehabilitation (PR) following discharge after an exacerbation of chronic obstructive pulmonary disease (COPD) is low in many health care systems. Surveys documenting this underutilization may ignore the fact of disease severity or co...

Background Auscultation is a simple physical examination that provides important clinical information. Many educational materials are available to facilitate students’ understanding of lung auscultation. Some studies and teaching materials have visualized lung sounds as spectrograms. However, their effectiveness as educational tools remains unclear...

Background Asthma and COPD are among the most prevalent chronic respiratory conditions, with inhalers as their primary pharmacological treatment. In the UK, metered-dose inhalers (MDIs) account for 70% of all inhaler prescriptions and contribute significantly to the NHS’s carbon footprint, making green prescribing a critical focus. Aligning environ...

Williams-Campbell syndrome (WCS) is a rare congenital disorder characterised by the absence of cartilage in sub-segmental bronchi, leading to bronchiectasis. We report a case of a late adolescence male presenting with chronic respiratory symptoms initially misdiagnosed as asthma, later confirmed to have WCS following detailed evaluation. This case...

Objective To retrospectively investigate the utilization patterns and clinical indications of acupuncture within the pediatric population in general hospitals from 2015 to 2020, including disease spectrum characteristics and relevance to pediatric subspecialties. Methods The clinical data of pediatric inpatients consulted by Acupuncture-Moxibustio...

Background Gut microbiota dysbiosis has been implicated in pulmonary arterial hypertension (PAH). However, the exact roles and underlying mechanisms of multi-kingdom gut microbiota, including bacteria, archaea, and fungi, in PAH remain largely unclear. Methods The shotgun metagenomics was used to analyse multi-kingdom gut microbial communities in...

Background Severe sarcoidosis has been associated with peripheral blood (PB) total lymphopenia and high tumour necrosis factor α (TNF-α) levels, and the lymphopenia phenotype seems to respond poorly to conventional treatment. However, the mechanisms behind PB lymphopenia and its correlation with TNF-α levels remain unclear. Understanding the connec...

Background Allergic rhinitis is a common disease that can affect the health of patients and bring huge social and economic burdens. In this study, we developed a model to predict the incidence rate of allergic rhinitis so as to provide accurate information for the treatment, prevention, and control of allergic rhinitis. Methods We developed a Long...

This report relates to a study group hosted by the EPSRC funded network, Integrating data-driven BIOphysical models into REspiratory MEdicine (BIOREME), and supported by SofTMech and Innovate UK, Business Connect. The BIOREME network hosts events, including this study group, to bring together multi-disciplinary researchers, clinicians, companies an...

Respiratory syncytial virus (RSV) causes substantial morbidity and mortality across the lifespan, with the highest burden seen in infants and older adults. Recently approved immunizing agents, including long-acting neutralizing monoclonal antibodies and a maternal vaccine for passive immunization of newborns, and three vaccines for adults aged 60 y...

Background Pleural effusion is a common disease in respiratory medicine, and rheumatoid arthritis (RA) is one of the causes of pleural effusion. Felty’s syndrome is a special manifestation of RA. We report a case of Felty’s syndrome with pleural effusion as the initial symptom and the subsequent diagnosis and treatment of the patient’s secondary py...

A female patient who was 65 years of age came for a consultation at the respiratory medicine outpatient department, primarily complaining of severe breathlessness even on minimal exertion, chronic productive cough for 4 months, and generalized chest pain. A detailed history taking revealed a history of pulmonary tuberculosis (TB) 15 years back, dur...

Guidelines recommend that patients with severe atopic dematitis (AD) be treated with Janus kinase inhibitors (JAKi). Recently, the safety of JAKi as a class was reviewed by the European Medicines Agency, leading to a modification of the Summaries of Product Characteristics. For upadacitinib, changes involve reduced posology and restriction of its u...

This review discusses the current applications of hydrogels in the management of airway lung injury and ventilator-associated pneumonia (VAP), with a particular focus on their potential impact in clinical practice. Research indicates that hydrogel technology can not only enhance airway management and promote lung tissue repair but also significantl...

Rationale While there are numerous published paediatric asthma scores, it is unknown how commonly scores are recommended in asthma guidelines across different geographical regions globally, and what their validation status is. Objectives (1) To describe which clinical guidelines recommend asthma scores across different geographical regions. (2) To...

La paracoccidioidomicosis es una micosis sistémica exclusiva de Latinoamérica causada por hongos dimórficos del género Paracoccidioides. Infrecuente en Uruguay, se vincula a la actividad forestal en el litoral norte del país. Las manifestaciones clínicas son inespecíficas, con afectación principal pulmonar, mucocutánea, ganglionar y/o visceral. Tie...

Background The current gold standard for the detection of bloodstream infections has several limitations, including a low positivity rate, a high contamination rate, and a lengthy flow cycle. Droplet digital polymerase chain reaction (ddPCR), a novel technique offering high sensitivity and specificity and the ability to provide absolute quantificat...

Naldemedine, a peripherally acting μ-opioid receptor antagonist, is used to treat opioid-induced constipation (OIC). However, it causes diarrhea as an adverse effect. This retrospective study aimed to investigate whether the occurrence of diarrhea was dependent on the timing of naldemedine treatment initiation. Inpatients who were initially treated...

Pulmonology and respiratory medicine have witnessed remarkable advancements in diagnostic and treatment modalities over the last decade. Innovative technologies such as artificial intelligence (AI), molecular diagnostics, and minimally invasive procedures have transformed the landscape of respiratory care. This paper explores novel approaches to th...

Objective The Wrightington, Wigan, and Leigh NHS Teaching Hospitals Foundation Trust (WWL) developed a novel virtual ward (VW) service that integrated with community and primary care, supported healthcare throughout a patient’s journey, and had a clinical workflow that could step-up or step-down care as needed. We described their VW and evaluated c...

Background Thyroid hormones play a crucial role in numerous physiological processes, including pulmonary function. However, the relationship between thyroid function and different patterns of pulmonary ventilation remains unclear. Methods This study employed a bidirectional two-sample Mendelian randomization (MR) approach combined with a cross-sec...

Radiological imaging is a cornerstone in the clinical workup of lung diseases. Radiomics represents a significant advancement in clinical lung imaging, offering a powerful tool to complement traditional qualitative image analysis. Radiomic features are quantitative and computationally describe shape, intensity, texture and wavelet characteristics f...

Kartagener syndrome (KS) is a rare autosomal recessive genetic disease characterized by visceral inversion, sinusitis and bronchiectasis. Small-cell lung cancer, a common tumor with poor prognosis, rarely coexists with KS. The lack of typical clinical symptoms can lead to missed or incorrect diagnoses, and to date, only few cases of this combinatio...

Ammonia is one of the most commonly produced chemicals in the world, with uses in agriculture, household cleaning, and as an alternative fuel source. While typically encountered in low concentrations, pure anhydrous ammonia in its gaseous form is extremely toxic and a potent caustic. We report the case of a previously healthy 19-year-old with prolo...

What is this summary about? ● This is a plain language summary of two articles originally published in The New England Journal of Medicine and The Lancet Respiratory Medicine. These articles presented the results of GALATHEA and TERRANOVA, two clinical studies that took place across 41 countries. ○ GALATHEA and TERRANOVA measured how patients’ COPD...

Background Pneumonia caused by Chlamydia abortus (C. abortus) is uncommon, particularly when complicated by severe acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS). Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal disease characterized by the uncontrolled activation and non-malignant...

Extrapulmonary tuberculosis (EPTB) is a multifaceted disease that could potentially impact nearly all organs. Current global data indicate a significant variation in the proportion of EPTB among all tuberculosis cases, ranging from 15% to 53%. Clinicians in India express concerns about the efficacy of the cartridge-based nucleic acid amplification...

Background The diagnosis of chronic obstructive pulmonary disease (COPD) is based on spirometry that requires a forced expiratory manoeuvre, which is laborious and difficult for mass screening. Impulse oscillometry (IOS) is easier than spirometry and performed with tidal breathing. We sought to develop an equation for predicting forced expiratory v...

Doxycycline is commonly used in respiratory medicine to treat bacterial lower respiratory tract infections and is also a frequent choice in dermatology for various skin conditions. However, neuropsychiatric adverse reactions to doxycycline are rarely documented in the literature. Even less frequently reported is the persistence of such reactions fo...

Sex and gender differences significantly influence lung parenchyma development, beginning as early as the embryonic stages of human life. Although this association is well known in the clinical manifestations of some relevant pulmonary diseases, there is less data available regarding their effects on cell biological programmes across different stag...

Obstructive Sleep Apnea afflicts an estimated 1 billion people worldwide. Untreated, Obstructive Sleep Apnea is linked with elevated levels of mortality, decreased quality of life and increased economic costs. However, several large population studies demonstrate that the efficacy of Continuous Positive Airway Pressure therapy, the most frequently...

Hypoxia Mechanisms Insights for Clinical Practice in Respiratory Medicine , Lung pathology remains a significant contributor to morbidity and mortality globally, emphasizing the importance of understanding fundamental lung physiology and its relationship to pathological conditions. The pulmonary system plays a critical role in oxygen delivery and c...

An outbreak of coronavirus disease 2019 (COVID-19), initially reported in December 2019 in Wuhan, Hubei Province, China, emerged as a mysterious pneumonia caused by the novel β-coronavirus, 2019-nCoV. Among hospitalized COVID-19 patients, elevated D-dimer levels and impaired hemostasis have been commonly observed, often associated with disease seve...

Researchers and the ERJ editor-in-chief advocate for more sustainable clinical trials. Environmental considerations should be integrated from trial funding to dissemination. Stakeholders, including researchers, are urged to take action on 14 items. https://bit.ly/3CAJgeX

Pulmonary function tests are used to diagnose and monitor lung diseases. They provide information about lung volumes, airflow, and gas exchange. Common indications for PFTs include: [16] Chronic cough, wheezing, or shortness of breath Abnormal chest X-rays Monitoring of chronic lung diseases (e.g., COPD, asthma, interstitial fibrosis) Perioperative...

Today occupational lung diseases rates as one of the most common work related illness and therefore an issue of great priority in the industrialized countries and also increasingly in the developing countries. Air pollution is one of the most important etiological factor in developing occupational lung disease to those who exposed to it. Today's ur...

Background Patient-ventilator asynchrony (PVA) can result in ventilator-induced lung injury (VILI), prolong mechanical ventilation, and ventilator withdrawal failure. The ability of healthcare providers in China to recognize patient-ventilator asynchrony is unknown. The aim of our study was to evaluate the ability and potential influencing factors...

Introduction Tuberculosis, caused by Mycobacterium tuberculosis, is a major global health issue, particularly prevalent in developing countries. While it primarily affects the lungs, it can disseminate to other organs, including the breast. Conversely, breast cancer is one of the most prevalent malignancies among women worldwide, characterized by a...

Background Tubercular lymphadenitis (TBLN) is the most common extrapulmonary tuberculosis (EPTB) followed by tubercular pleural effusion (TPE). The bacteriological confirmation to diagnose EPTB is more difficult due to its paucibacillary nature often leading to delay or misdiagnosis. The role of the CBNAAT test for the diagnosis of EPTB is highly v...

In vitro studies and observational human disease data suggest the complement system contributes to SARS-CoV-2 pathogenesis, although how complement dysregulation develops in severe COVID-19 is unknown. Here, using a mouse-adapted SARS-CoV-2 virus (SARS2-N501YMA30) and a mouse model of COVID-19, we identify significant serologic and pulmonary comple...

Objective This study aimed to quantitatively assess nursing practices related to palliative sedation (PS) among nurses in respiratory medicine wards (RMWs) and palliative care units (PCUs) and to identify factors influencing these practices. Methods A nationwide cross-sectional survey was conducted among nurses in 25 RMWs and 35 PCUs in Japan. A t...

BACKGROUND: Diffuse Parenchymal Lung Diseases(DPLD) is a group of disease which leads to progressive deterioration in the lung function, physical performance and quality of life. Addressing issues like breathlessness cough and psychological aspects like stress, depression and career loss are the major aspects in improving the quality of life of peo...

Tuberculous pleural effusion (TPE) remains a significant health concern globally, particularly in countries like Bangladesh where the burden of tuberculosis is substantial. It has posed a great challenge to us in its management due to increasing drug resistance and the long duration of treatment. Vitamin D has a recognized role in immune modulation...

The prevalence of asthma has grown steadily over the decades in developing countries like Bangladesh. A cross-sectional, observational study was carried out in the Department of Pharmacology & Therapeutics in collaboration with the Department of Respiratory Medicine and Internal Medicine of Mymensingh Medical College Hospital, Mymensingh, Banglades...

Objective To investigate the respiratory signs observed in individuals hospitalized due to dengue infection. Methods This observational study encompassed a cohort of 50 individuals diagnosed with dengue fever, as confirmed by the presence of NS1 antigen, who were hospitalized to Shaheed Captain Mansur Ali Medical College Hospital in Uttara, Dhaka,...

Objective This study aims to evaluate the utility of targeted next-generation sequencing (tNGS) in bronchoalveolar lavage fluid (BALF) for hospitalized patients with pulmonary infections. Methods A cohort of 358 patients who received diagnosis and treatment for respiratory infections in the department of Respiratory Medicine at Wenzhou People’s ho...

Background: Individuals with Preserved Ratio Impaired Spirometry (PRISm), defined as FEV1/FVC ≥0.7 and FEV1 <80% predicted, are at higher risk of developing COPD. However, data for Australian adults are limited. We aimed to describe prevalence of PRISm and its relationship with clinical characteristics in Australia. Method: Data from the Burden of...

A woman in her mid-30s, with no prior comor-bidities presented to the pulmonology department with complaints of low-grade fever, dry cough, progressive shortness of breath for 4 months and bipedal oedema for the last 1 month. She had no urinary complaints nor any symptoms suggestive of heart failure. Obstetric and family history was insignificant....

Study Design: A retrospective study.Purpose: This study aimed to determine the impact of increased Hounsfield unit (HU) values for metastatic spinal lesions measured via computed tomography on the overall survival of patients with non-small-cell lung cancer (NSCLC) and identify factors associated with increased HU values in metastatic spinal lesion...

Mycobacterium avium complex (MAC) pulmonary disease presents significant therapeutic challenges in respiratory medicine. While amikacin liposome inhalation suspension (ALIS) has emerged as a promising option for treatment-refractory cases, some patients continue to show persistence of infection. We report a case of a 64-year-old male with MAC pulmo...

Reviewer acknowledgement 2024 The editors and staff of Multidisciplinary Respiratory Medicine would like to warmly thank the reviewers whose comments helped to shape the journal, for their invaluable assistance with review of manuscripts in Volume 19 (2024).

This review article examines the relationship between microbial communities and asthma, emphasizing the microbiome's significant role in asthma development and therapy. Recent developments in the study of the microbiome have shed light on the intricate role that microbial populations play in the etiology and management of asthma. This paper examine...

A BSTRACT Introduction Chronic respiratory symptoms (dyspnoea, coughing, sputum production) associated with abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that result in persistent, frequently progressive airflow obstruction are the hallmarks of COPD, a diverse lung illness. The current investigation aimed to e...

COPD is one of the leading causes of death worldwide, so it represents a significant public health challenge. Over the years, new effective therapies have been proposed. However, the burden of COPD is still conditioned by frequent acute events defined as exacerbations (exacerbation of COPD-ECOPD), which have a significant impact not only on the pat...

Evaluating the Risk of obstructive sleep apnea by using the STOP-BANG questionnaire in type 2 diabetic patients Background: Type 2 diabetes and obstructive sleep apnea (OSA) are chronic diseases with an interrelationship that increases cardiovascular events, mortality and quality of life. Objective of this study was to determine the risk of obstruc...

Tuberculosis (TB) is a highly infectious disease and a global health challenge caused by Mycobacterium tuberculosis. The disease presents as drug-sensitive TB or drug-resistant TB (DR-TB). DR-TB could be of various types like isoniazid mono-resistant, multidrug-resistant (MDR)-rifampicin mono-resistant (MDR-RR), MDR-TB, extensively DR-TB (XDR-TB),...

La universidad médica ha tenido como prioridad la actualización y preparación de los profesionales que laboran en el Sistema Nacional de Salud. Ello incluye, como aspecto prioritario la atención de enfermería a pacientes con cáncer de pulmón avanzado. En este sentido, se identificó como objetivo valorar la satisfacción de una Estrategia Interventiv...

Los desafíos de la Asociación Colombiana de Neumología y Cirugía de Tórax para 2025 incluyen un plan desafiante que abarca la actualización de la imagen institucional, la revisión de documentos de procedimientos médicos asociados a nuestras especialidades y la realización del 21° Congreso Colombiano de Neumología y Cirugía de Tórax. En el campo clí...

Objetivo: Elaborar un algoritmo de tratamiento en pacientes con alergia a la penicilina. Métodos: Estudio retrospectivo, efectuado en pacientes adultos con alergia a la penicilina, que permanecieran en el grupo 3 o 4 de la clasificación establecida, y asistieron a consulta ambulatoria en el Departamento de Neumología y Alergia del Hospital Central...

The evolution of artificial intelligence (AI) has revolutionised numerous aspects of our daily lives, with profound implications across various sectors, including healthcare. Although the concept of AI in healthcare was introduced in the early 1970s, the integration of this technology in healthcare is still in the evolution phase. Despite barriers,...

Contactless measurement methods offer a novel approach to assessing respiratory parameters. This study investigates the feasibility of classifying chronic obstructive pulmonary disease, asthma, and healthy individuals using depth-based plethysmography (DPG). The approach involves calculating Pearson's correlation coefficient for all pixel-wise sign...

Digital twins have recently emerged in healthcare. They combine advances in cyber–physical systems, modelling and computation techniques, and enable a bidirectional flow of information between the physical and virtual entities. In respiratory medicine, progress in connected devices and artificial intelligence make it technically possible to obtain...

Endobronchial lesions, originating from the bronchial wall, range from benign to malignant and include types such as squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. They usually have similar clinical and radiological presentation making it difficult to distinguish them from one another. Fiberoptic bronchoscopy is one of the impor...

Intranasal dexmedetomidine administration in clinically recommended doses has a small but important risk of causing catastrophic respiratory failure in the setting of preexisting severe respiratory workloads.

Conventional imaging modalities, the X-ray and CT, are essential diagnostic tools in respiratory medicine, providing qualitative information regarding the pattern and extent of pulmonary pathology. Neither provide information regarding the functional impact of pulmonary diseases and additional investigations are required to assess this. Hyperpolari...

Introduction: Pleural infections are a significant cause of mortality. Intrapleural fibrinolytic therapy (IPFT) utilising alteplase and dornase is a treatment option for patients unsuitable for surgery. The optimal dose of alteplase is unknown, and factors affecting treatment success in an Asian population are unclear. We sought to determine the fa...

Respiratory diseases pose a major public health challenge globally, necessitating collaborative efforts between basic researchers and clinicians for effective solutions. China, which is heavily impacted by a broad spectrum of respiratory disorders, has made notable strides in both research and clinical management of these diseases. The Internationa...

A BSTRACT Context An inhaled corticosteroid (ICS) in combination with a long-acting β2-agonist (LABA) is a common treatment approach for asthma patients not controlled on ICS alone, but a significant proportion of patients remain uncontrolled on this combination and treatment adherence can also be a challenge. One of the options for adults whose a...

This report relates to a study group hosted by the EPSRC funded network, Integrating data-driven BIOphysical models into REspiratory MEdicine (BIOREME), and supported by SofTMech and Innovate UK, Business Connect. This report summarises the work undertaken on a challenge presented by two of the authors, Mathew Bulpett and Dr Emily Fraser. The aim w...

Background This qualitative study aims to deeply understand the emotional experiences of mutuality relationships between lung cancer patients undergoing chemotherapy and their caregivers, providing insights for developing cancer-related mutuality interventions. Methods Using a qualitative research method with semi-structured interviews, 15 pairs o...

Respiratory diseases pose a major public health challenge globally, necessitating collaborative efforts between basic researchers and clinicians for effective solutions. China, which is heavily impacted by a broad spectrum of respiratory disorders, has made notable strides in both research and clinical management of these diseases. The Internationa...

Tracheal tumors and stenosis represent significant chal lenges in respiratory medicine, often requiring invasive interventions that come with high risks and potential complications. The literature surrounding innovation in its management has evolved significantly over the years, reflecting a shift towards more refined and less invasi ve. Tradit...